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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: §88-7904 <br /> <br /> Other <br /> I have read and 8(Iree t~ the terms stated on the reverse side of <br /> <br /> DATE: 01/29/'92 TitlE: 12:37:43 <br />OWNCR: <br /> RiESf ERER, BERNARD <br /> <br /> 8521 HOLMQUIS'f' RD SE <br />AU~ISVI LLE OR 9'7325 <br /> <br /> NANuFAC'f'URED STRUCTURE <br />MAILINO ADDRESS~ <br /> <br />P_O BOX 255 <br />SLJBLIMI'f'Y, OR 9?385 <br />PHONE: 585-?420 <br /> <br /> LOT: BLOCK: SECTION: TOWNSHIP; <br /> 3 '1 8S <br />:WIDTH; DEPTH: AREA~ UNITS: <br /> 2.88 AC <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> TAX LOT: CATEGORY: <br /> 56351-815 RES i DEN 11A <br /> <br /> CONSTRUCTION TYPE'. ©CCUPANCY; <br /> <br />CONTRACT CITY: UGB; OCCUPANT LOAD. <br />M.ARi ON COUNTY NO <br /> <br />2 <br /> <br />FLOODPLAIN <br /> <br /> SITE NUMBER: 92-00223 <br /> VALUA'f'iON: <br /> <br />RANGE: ZONE: <br />AR <br /> <br /> NO NO <br /> <br />MAP: <br /> <br />'f'YPB$ MANUFACTURE0 STRUCTURE PERNI'T' OR APPLICAI'ION NO: <br /> <br />OON'f'RACTOR, NO. <br />RiES'1'ERER, BERNARD <br /> BOX 255 <br />~i~P, JBLIMiI'Y. OR 9?385 <br />RHONE~ 585-?420 <br /> <br />ITEM <br />NANUFAC'T'URED ~'f'RUC'IURE PLACENE74'T'/CONNEC'FioN <br />~&NUFACTUREO STRUCTURE STATE FEE <br />F~IANUFAC'rUREB STRUCTURE STATE SURCHARGE <br />MANUFACt'UREB STRUCTURE ZONING SURCHARGE <br /> <br />'rO'FAL A,SSESSED FEES <br />PREVIOUS RECEIPTS <br />I'Hi~ RECEIPT <br /> <br />3?842 <br /> <br />QUANIIFY AMOUN1 <br /> <br /> $20_00 <br /> $9. lO <br /> $15.00 <br /> <br />$226.18 <br />$226.1o <br />$o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> RECEIPT <br />'TYPE: CHECK ~: 0 <br /> <br />PAYEE: <br />RECEIVED <br /> <br /> ~ THIS iS A VALID PEI;~IT ~ THiS PEF~iT FEE COVERS ONE INSPECTION AND ONE REINSPECTioN. ALL <br /> ~LOCRING, STAIR INSTALLATION, PLUFclBING, MEONANICAL, AND ELECTRICAL CONNECTIONS ARE RE(~JIRED T¢ <br /> BE CO~IPLETED UPON REQUEST FOR THE FIRGT INSPECTION. IF ANY OF THE IT~ ARE iNCO~IPLETE. AN <br />AOB[TIONAL iNSPECTION FEE WILL BE RE(~UIREB. PER,lIT IS VALID FOR SIX ffl0NTHS ONLY. RENE~ED FGR <br />6 rflONTHS UPON HRiTTEN RE(]UE~T FOR AN EXTENSION, PRIOR TO THE EXPIRATION DATE OF THE pER,flIT. <br />IP CONSTRUCTION FAIL~ TO ~EET ALL REQUIRE~IENTS OF STATE LA~ AND ~RiON CCtINTY BUiLDiNG AND <br />ZONING ORDINANCES, THiS PER~[T SHALL BECOf*IE NULL AND VOID. <br /> <br />SETBACKS: FR 20 LS ~0 RS 10 RR 40 ~P <br />RE~CARFg%: ~FIR~'I' FLOO~ tCJST-BE 3 'FEET ABO~E"E,~ISTiNGGRADE* SEE A'~ED ~CHORING <br /> REQUiREmENTS ~FL~D P~IN - SEE PLAN REVIE~ ~. ~ . <br />P~NNING AC'¢I~: , . ~ <br />O~ALB E ~ODLEY, ~RiON COUNTY BUILDiNG OP'FiCiAL / BY ............................ ~ <br /> <br /> OFFICE COPY <br />FORM ~ MC 15-56 REV, 4/90 <br /> <br /> <br />